To compare the result of snastomosis performed by EEA stapler with that by had suture, and to compare the result of loop esphagojejunostomy with that of Roux-en Y anstomosis after total gastrectomy we reviewed 303 patients treated during January
1990 to
December 1991 at Department of surgery, Seoul National University Hospital.
The patients performed esophagojejunostomy using hand suture technique were 113. The patients performed esophagojejunostomy using EEA stapling technique were 128.
@ES The patients performed esophagojejunostomy using Disposable EEA stapling technique were 62:
@EN 1) The average operating time was 245 minutes in hand suture group, 227 minutes in EEA group.
2) The amount of average blood transfusion during operation were 1.2 pint in hand suture group, and 0.7 pint in EEA group.
3) The leakage rate were 5.3% in hand suture group, and 2.1% in EEA group. The stricutre rate were 0.9% in hand sture group, and 0.5% in EEA group. There was no bleeding at anastomosis site in both groups.
The overall complication rate were 6.2% in hand suture group, and 2.6% in EEA group.
4) The mortality related to esophagojejunostomy were 0.9% in hand suture group, and 0.5% in EEA group.
5) The average postoperative hospital stay were 18.1 days in hand suture group, and 16.6 days in EEA group.
6) The postoperative leakage rate in EEA group was 3.1%, but there was no postoperative leakage in disposable EEA group. the mortality related to esophagojejunostomy were 0.8% in EEA group, 0% in disposable EEA group. The average operating time
were
231 minutes in total gastrectomy with EEA stapler, and 216 minutes in total gastrectomy with disposable EEA stapler. The amount of averge blood transfusion during operation were 0.9 pint in EEA group, nd 0.3 in disposable group(p<0.05).
The average postoperative hospital stay were 18.2 days in EEA group, and 14.8 days in disposable EEA group(p<0.05)
7) The average operating time were 254 minutes in Roux-en Y anastomosis group, and 209 minutes in loop esopha-gojejunostomy group.
The leakage rate was 2.9% in Roux-en Y anastomosis group, and 1.8% in loop esophagojejunostomy group.
8) The conclusions are as follows:
EEA stapler can simplify and facilitate esophagojejunal anastomosis after total gastrectomy. The disposable EEA stapler was superior to EEA stapler at least. The loop esophagojejunostomy was more reliable reconstructive method than Roux-en Y
anastomosis
after total gastrectomy in regard to operating time and leakage rate at anastomosis site.
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